There is hardly a biomedical informatics startup business plan that does not include the two words “Artificial Intelligence.” Our own academic centers are making or considering making industrial alliances to apply AI techniques to our data to improve care, improve cost-efficacy and advance science. However, this is not the first hype cycle for AI in Medicine. When I was a graduate student in the 1980’s there was a ferment very similar to the one now. However, I am more optimistic that AI will have a bigger impact on medicine today than it did 30 years ago. I will explain this in the context of the more recent advances and also point out how the very high stakes (financial and knowledge-control) are very much still in play. I will conclude with what I believe to be the central role that clinical informaticians can play in leading and safely implementing AI in Medicine.